For some people, deciding whether to do treatment is not always an easy decision. There are a lot of factors to be considered including the adverse effects that can be caused by the drugs used to treat people. It can also be an emotive issue - some people have strong views about the pharmaceutical industry or about chemicals that are not natural. It may help to try to put any prejudices aside and concentrate on the pro and cons of treatment itself:
The pros of doing treatment
The major advantage that treatment offers is that it is the only proven way of clearing the virus. People have undoubtedly cleared the virus in other ways but only in very small numbers and there has been no other way that has been proven to work consistently.
Treatment has been shown to improve the health of the liver by reducing inflammation. It may also be able to reverse fibrosis or even cirrhosis. This can happen, although less often, even in people who do not clear the virus.
Aside from health, there may be other benefits from clearing the virus, for example, financially. You should find that any insurance connected with your health becomes significantly cheaper and this could make an important difference to your mortgage. If hepatitis C has made you incapable of working, once clear of the virus, you may find you can go back to work. It may also help how you feel about yourself, your self-image, that you are no longer carrying an infectious virus.
If you are a woman, although it is small, there is a risk of passing hepatitis C to any child you give birth to. Clearing the virus would remove that risk.
If treatment is successful then you no longer risk infecting other people, i.e. by sharing a tooth brush or razor.
The cons of doing treatment
The major disadvantage to treatment consists of the side effects. Not everyone experiences them. There are things you can do to keep them to a minimum but, even so, you may feel quite unwell some of the time. It can take some months after treatment ends before the drugs are cleared from your system with Ribavirin taking up to 6 months to clear. This could impact on your work (you might have to take time off), on your relationships, on your social life. This might mean you have to tell people that you are doing treatment and therefore that you have hepatitis C.
Occasionally, the side effects can be so severe that they could force you to abandon treatment. You could be left with an illness after you stop treatment, such as thyroid disease or diabetes.
Treatment might not work for you
Some people have reported that the side effects have persisted, leaving them feeling unwell long after the end of treatment.
These are the general pros and cons. On top of them, your own individual circumstances will have an important bearing. Some of these you may want to take into account are:
What your priorities are. Is clearing the virus your top priority?
Your individual chances of clearing the virus. This will be most dependent on your genotype. Roughly speaking, you have a 50% chance if you are genotype 1 and an 80% chance if you are genotype 2 or 3.
How long you will need to do treatment. If you are genotype 2 or 3, it will only last 24 weeks. If you are any other genotype (or if you have other complications) it will last 48 weeks, which is almost a year. This makes a difference
Whether you can/are prepared to wait for the possibility of better drugs. If, say, you have compensated cirrhosis, can you risk it de-compensating before new drugs become available?
How well you will be able to deal with any side effects. Will you have the support you need?
Your ability to plan your life around treatment. Can you be available for hospital visits, which are fairly frequent? Can you take time off work or other responsibilities if you have to?
Are you thinking of conceiving a child in the next year? (you should not conceive, as either a man or a woman, during treatment or for at least 6 months afterwards)
The best way to come to the right decision is to inform yourself as fully as possible and the following sections about conventional treatment are intended to help you do that. Please take the time to read through them.
Once you are informed, discuss it with your doctor. The idea behind medicine in the 21st century is that you and your doctor should work in partnership to improve your health. We are no longer in the era where the patient obediently does whatever the doctor says. So, a word of warning - deciding whether to do treatment is rarely clear cut and, if anyone makes out it is and that its obvious what you should be doing, it may be because they have an agenda that is different from yours. This could include your doctor. If he/she really pushes you for or against treatment, arm yourself with the facts and ask why.
